| NPI | 1235124314 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: TX F6842) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: TX TXF6842) |
| Enumeration Date | 2005-09-15 |
| Last Update Date | 2018-08-20 |